Effects of social skills training for drug users under treatment / Efeitos do treinamento em habilidades sociais para usuários de substâncias em tratamento / Efectos del entrenamiento en habilidades sociales para usuarios de sustancias en tratamiento

The Social Skills Training (SST) presents satisfactory results in different clinical and non-clinical populations. The objective of this study is to evaluate the effects of SST on the perception of quality of life of drug users under treatment in post-intervention and follow-up conditions. It is a quasi-experimental study. The instruments used in the study were: CHASO, EMES-M, Extensive Interaction Semi-structured Test and WHOQOL. The study sample was composed of forty male drug users who participated in SST in a Therapeutic Community. The results indicate a statistically significant increase in the ability of defending rights, dealing with and keeping calm upon criticism, with medium effect size on the ability to refuse requests, refuse drugs and quality of life (psychological domain). SST was found to contribute to the development of specific social skills and as a complementary strategy in the Therapeutic Community. (AU)

O Treinamento em Habilidades Sociais (THS) apresenta resultados satisfatórios em populações clínicas e não clínicas. Objetiva-se avaliar os efeitos do THS na percepção de qualidade de vida e habilidades sociais de usuários de substâncias em tratamento nas condições de pós-intervenção e follow-up. Trata-se de um estudo quase-experimental. Os instrumentos utilizados foram: CHASO, EMES-M, Teste Semiestruturado de Interação Extensa e WHOQOL. Participaram 40 homens usuários de substâncias que participaram do THS em uma Comunidade Terapêutica. Os resultados apontam para um aumento estatisticamente significativo nas habilidades de defesa de direitos, enfrentar e manter a tranquilidade diante das críticas, com tamanho de efeito médio nas habilidades de negar pedidos, recusar a droga e qualidade de vida (domínio psicológico). Identifica-se que o THS contribui no desenvolvimento de habilidades sociais específicas, sendo uma estratégia complementar do tratamento na Comunidade Terapêutica. (AU)

El Entrenamiento en Habilidades Sociales (EHS) proporciona resultados satisfactorios en poblaciones clínicas y no clínicas. El objetivo de este estudio fue evaluar los efectos del EHS en la percepción de la calidad de vida y las habilidades sociales de los usuarios de drogas bajo tratamiento en condiciones de post-intervención y seguimiento. Se trata de un estudio cuasi-experimental Los instrumentos utilizados fueron: CHASO, EMES-M, Test Semiestructurado de Interacción Extensiva y WHOQOL. La muestra del estudio se compuso por cuarenta varones usuarios de drogas que participaron en el EHS en una Comunidad Terapéutica. Los resultados apuntan a un aumento estadísticamente significativo en la capacidad de defensa de derechos, afrontar, mantener la tranquilidad frente a las críticas, con un tamaño de efecto promedio en la denegación de peticiones, rechazo de drogas y calidad de vida (dominio psicológico). Se comprueba que el EHS contribuye al desarrollo de habilidades sociales específicas como una estrategia complementaria de tratamiento en la Comunidad Terapéutica. (AU)

Concretizing occupational justice principles in Philippine community-based drug rehabilitation practice settings

Background@#The substance addiction and rehabilitation situation in the Philippines is a complex health and social crisis that has plagued individuals, groups, and communities in the past decades. While pluralistic and critical approaches to address the drug demand reduction issue are available, hegemonic practices continue to eclipse evidenceinformed approaches underpinned by resiliency and occupational justice perspectives. @*Methodology@#This case study utilized a qualitative and interpretive approach to describe the practice processes of localized community-based drug rehabilitation programs in selected Filipino communities and to propose concrete practice processes to improve the development and implementation of the local community-based drug rehabilitation. Two independent focus group discussions were conducted. Participants were health care professionals, community workers, and citizens who have an affinity to the substance addiction rehabilitation setting. Framed by the Participatory Occupational Justice Framework, specifically the practice process “engage collaboratively with partners,” qualitative data extracted from the focus group discussions were thematically analyzed. @*Results@#Three themes emerged: (1) Changing perspective: starting from the community; (2) Better together: collaboration and coordination in substance addiction and rehabilitation; and (3) “Juan for All, All for Juan”: contextualized strategies in substance addiction and rehabilitation. The findings in the case study reaffirm the value of shifting from an individualistic (symptom-eradication) to populational (social and systemic interventions) perspectives in developing community-based drug rehabilitation programs. @*Conclusion@#To reify occupational justice and resiliency approaches, proposed strategies include understanding drug use from critical and occupational perspectives, enacting social modeling and mentorship, promoting inter-agency and inter-professional collaborative practices, and infusing culturally appropriate strategies in the development and implementation of local community-based drug rehabilitation programs.

A single-case quasi-experimental design of functional analytic psychotherapy for substance abuse / Um delineamento quase-experimental de caso único da psicoterapia analítica funcional para abuso de substâncias / Un diseño de caso único cuasi experimental de psicoterapia analítica funcional para abuso de sustancias

This study evaluated the effectiveness of Functional Analytic Psychotherapy (FAP) on clinically relevant behaviors (CRBs) in the context of substance abuse/chemical de pendence and identifying the therapeutic components of change. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to categorize therapist and client behaviors, and Timeline Followback was used to record drug abuse. Two participants were treated in a single case A/A + B quasi-experimental design, in which A = analytical-behavioral therapy and A + B = FAP. The results showed that with the introduction of FAP, specifically the therapist's contingent responding to the participant's progress, there was a decrease in the use of substances after three months for both participants. The participant who spent more time in psychotherapy experienced greater benefits at follow-up and a larger reduction in drug use. We concluded that FAP altered CRBs by positively reinforcing progress in-session and was significantly correlated with improvement out-of-session.

O objetivo da pesquisa foi avaliar o efeito da Psicoterapia Analítica Funcional (FAP) sobre os comportamentos clinicamente relevantes (CRBs) e abuso de substâncias de dependentes químicos e identificar os componentes terapêuticos de mudança. Foram utilizados os instrumentos Functional Analytic Psychotherapy Rating Scale para categorização de comportamentos do terapeuta e cliente e Timeline Followback para registrar o abuso de drogas. Dois participantes foram atendidos em um delineamento quase-experimental de caso único A/A+B, onde A = Terapia Analítico-Comportamental e A+B = FAP. Os resultados indicaram que a introdução da FAP, em especial o responder contingente do terapeuta, acompanhou os progressos e houve melhora no consumo de substâncias após 3 meses para ambos. O participante que se manteve mais tempo em psicoterapia obteve maior benefício no follow-up e no consumo de drogas. Concluiu-se que a FAP alterou CRBs reforçando positivamente progressos em sessão e que isto provavelmente se correlacionou com melhoras extrassessão.

El objetivo fue evaluar el efecto de la Psicoterapia Analítica Funcional (FAP) en los comportamientos clínicamente relevantes (clinically relevant behaviors - CRBs) e el abuso de sustancias de dependientes químicos, e identificar los componentes terapéuticos de cambio. Se utilizaron Functional Analytic Psychotherapy Rating Scale, para clasificar los comportamientos del terapeuta y del cliente, y timeline followback, para registrar el abuso. Dos participantes fueron evaluados a través de un diseño cuasiexperimental de caso único A/A + B, donde A = terapia analítico-comportamental y A + B = FAP. Los resultados indicaron que la implementación de la respuesta contingente del terapeuta llevó a cambios en las CRBs y mejorías en el consumo de sustancias en los dos participantes después de tres meses de intervención. El participante que se mantuvo más tiempo en psicoterapia obtuvo mayor beneficio durante el seguimiento. Se concluye que FAP modificó las CRBs a través del reforzamiento positivo en sesión, lo que se relacionó con las mejoras fuera de sesión.

Tuberculosis in Selected Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in Luzon, Philippines

Background and Objectives@#Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015.@*Methods@#All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence.@*Results@#A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases.@*Conclusion@#The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.

Estudio de politicas publicas para el tratamiento de jóvenes adictos a la droga en Ecuador / Study of public policies for the treatment of young people addicted to the drug in Ecuador / Studio delle politiche pubbliche per il trattamento di giovani dedo alla drogas no Equador

Resumen Introducción: El consumo de drogas, es un tema de gran importancia, y un grave problema social, que no sólo aqueja a nuestro país, Ecuador, sino que su afectación es a nivel mundial, tomando en consideración que llega incluso a ocasionar graves daños en la salud, en la convivencia social y la seguridad ciudadana. Objetivo: Proponer y difundir estrategias integrales para la rehabilitación y reinserción de los jóvenes adictos a las drogas. Materiales y métodos: Se implementó una encuesta a 40 jóvenes comprendidos entre los 18 a 25 años de edad, de diferentes clases sociales. Resultados: Se determinó que el consumo de drogas va en aumento, a causa de problemas familiares y la influencia de amistades y redes sociales; así como también, se determina que un alto porcentaje de los encuestados desconoce las normativas que regulan la adicción en el Ecuador y las Políticas de Estado, creadas para la debida rehabilitación y reinserción de los adictos a la sociedad. Conclusión: Se proyecta a través de los resultados obtenidos poner en conocimiento de la sociedad en general y en especial de los adictos, las normativas que regulan el problema de la adicción; así como, hacer conocer el tema de las Políticas Públicas que el Estado, ha creado en función de la prevención integral de esta problémica, con el fin de garantizar una vida digna.

Abstract Introduction: Drug use, is a subject of great importance, and a serious social problem, which not only afflicting our country, Ecuador, but that his involvement is at the global level, taking into consideration that even serious damage in health, social life and the citizen security. Objective: Propose and disseminate comprehensive strategies for the rehabilitation and reintegration of young people addicted to drugs. Materials and methods: A survey was implemented to 40 young people between 18 and 25 years of age, of different social classes. Results: It was determined that drug use is on the rise, because of family problems and the influence of friendships and social networks; as well as, it is determined that a high percentage of respondents unknown regulations governing the addiction in the Ecuador and State policies, created for the appropriate rehabilitation and reintegration of addicts into society. Conclusion: Is projected through the results bring to the attention of society in general and in particular of addicts, the norms that regulate the problem of addiction; as well as, make known the issue of public policy that the State has created based on comprehensive prevention of this problem, in order to ensure a dignified life.

Resumo Introdução: Uso de drogas, é um assunto de grande importância e um grave problema social, que não só que afligem nosso país, o Equador, mas o seu envolvimento é a nível global, levando em consideração que até mesmo sérios danos na saúde, vida social e a segurança dos cidadãos. Objetivo: Propor e divulgar estratégias globais para a reabilitação e a reintegração de jovens viciados em drogas. Materiais e métodos: Um levantamento foi implementado para 40 jovens entre 18 e 25 anos de idade, de diferentes classes sociais. Resultados: Determinou-se que o uso de drogas está em ascensão, por causa de problemas familiares e a influência de amizades e redes sociais; assim como, é determinado que uma elevada percentagem de inquiridos desconhecido regulamentos o vício nas políticas Equador e estado, criado para a adequada reabilitação e reinserção social de toxicodependentes. Conclusão: Projeta-se através dos resultados chamar a atenção da sociedade em geral e em particular dos viciados, as normas que regulam o problema da toxicodependência; bem como, dar a conhecer a questão das políticas públicas que o estado tem criado com base na prevenção abrangente deste problema, a fim de garantir uma vida digna.

Dependência química e fortalecimento psicossocial pelas práticas esportivas / Chemical dependency and strengthening psychosocial by sports practices / Dependencia química y fortalecimiento psicosocial por prácticas deportivas

A questão sobre o abuso de drogas tem manifestado a urgência por medidas que fomentem o tratamento sobre a mesma. O presente relato de experiência profissional procurou apresentar uma proposta de intervenção em que a prática esportiva foi utilizada como importante instrumento no processo de tratamento para pessoas com dependência de álcool e outras drogas. Foi percebido que a prática esportiva colaborou para o desenvolvimento dos recursos internos dos participantes, atuando como medida para o fortalecimento psicossocial dos usuários por meio do desenvolvimento da autoestima, perseverança, disciplina, superação, dentre outros.

The question of drug use has shown the urgent need for measures to promote the treatment of this question. This account of professional experience presented a proposal for intervention in which sports practice was used as an important tool in the treatment process for people with alcohol and others drugs. It was noticed that the sports practice contributed to the development of the internal resources of the participants, acting as a measure for the psychosocial strengthening of users through the development of self-esteem, perseverance, discipline, overcoming, among others.

La cuestión del uso de drogas ha demostrado la necesidad urgente de medidas para promover el tratamiento de la misma. Este relato de la experiencia profesional trató de presentar una propuesta de intervención en que se utilizó la práctica del deporte como una herramienta importante en el proceso de tratamiento para las personas con dependencia del alcohol y otras drogas. Se observó que la práctica deportiva ha contribuido al desarrollo de los recursos internos de los participantes, que actúa como una medida para el fortalecimiento psicosocial de los usuarios a través del desarrollo de la autoestima, la perseverancia, la disciplina, la superación, entre otros.

An analysis on the status of syphilis and HCV infection and influencing factors among community drug addicts in Jiaxing City / 预防医学

Objective To investigate the status of syphilis and HCV infection and the influencing factors among community drug addicts in Jiaxing City.Methods HCV and syphilis were detected among community drug addicts in Jiaxing City from 2014-2015 and a questionnaire survey were conducted.Influencing factors of syphilis and HCV was analyzed in this study.Results A total of 449 drug users including 356 males (79.29％) and 93 females (20.71％) were investigated,with the age ranged from 16 to 47 and averaged 27.50 ± 12.28.A total of 370 of them take addictive drugs (82.41％),including 42 of them take more than 2 kinds of drugs.15 cases of Syphihs (double positive) were found,and the positive rate was 3.34％.There were significant difference among community drug addicts with different education level (P ＜0.05).The positive rate of HCV among males were lower than that of females (P ＜ 0.05),and the positive rate of HCV among heroin addicts were higher than other drug addicts (P ＜ 0.05).The positive rate of HCV of injection drug users were higher than oral drug addicts(OR =17.341,95％ CI:8.387-35.857,P ＜ 0.01).There was associations among condom use with double positive syphilis and HCV (OR =0.210,95％ CI:0.064-0.689,P ＜0.01;OR =0.131,95％ CI:0.063 -0.273,P ＜ 0.01),respectively.Conclusion Community drug addics are mainly young adults,drug injection and not using condom may increase the risks of TP and HCV infection.

Políticas sobre drogas no Brasil: a estratégia de redução de danos / Drug policies in Brazil: the harm reduction strategy / Políticas sobre drogas en Brasil: la estrategia de reducción de daños

O presente artigo aborda a temática das políticas brasileiras referentes às drogas, com o objetivo de resgatar o histórico da estratégia de redução de danos (RD) no Brasil. A partir de pesquisa bibliográfica em sítios de domínio público e em bases de dados disponíveis na internet, rastreamos o surgimento da estratégia de redução de danos no País, cujo marco foi a epidemia da AIDS da década de 80 e as políticas que a antecederam. Os dados coletados suscitam reflexões sobre os desafios contemporâneos enfrentados pelo emprego da estratégia de RD no campo do uso e do abuso de drogas lícitas e ilícitas, como álcool e crack, o preconceito vigente em relação ao usuário de drogas e a exigência de intervenções intersetoriais no enfrentamento do fenômeno do consumo de drogas. Além disso, mantém-se até os dias atuais o descompasso histórico entre as políticas sobre drogas oriundas do campo da segurança e aquelas provindas da saúde pública, com predominância daquelas de cunho proibicionista. Enquanto isso, a produção de drogas lícitas e ilícitas se diversifica, gerando a necessidade de tornar variadas as ações de redução de danos.

This article brings the subject of Brazilian's policies about drugs, aiming to rescue the history of the harm reduction strategy - HR - in Brazil. With bibliographic research using public domain websites and data bases available on the internet, we traced the origin of the harm reduction strategy in the country, which began with the AIDS epidemic in the 80's, and the policies that were implemented before the HR strategy. The collected data evokes reflections about the contemporary challenges that the application of HR strategy faces in the use and abuse of drugs, such as alcohol and crack, the predominant prejudice related to drugs' users and the exigency of intersectorial interventions for the consumption of drugs confrontation. Moreover, the conflict between the drug policies of the security and health fields continues until nowadays, with predominance of the prohibitionist model. Meanwhile, the production of licit and illicit drugs diversifies, what shows the necessity of different harm reduction strategies.

El presente artículo aborda la temática de las políticas brasileras referentes a las drogas, con el objetivo de rescatar el historial de la estrategia de reducción de daños (RD) en Brasil. A partir de una investigación bibliográfica en sitios de dominio público y en bases de datos disponibles en Internet, rastreamos el surgimiento de la estrategia de reducción de daños en el País, cuyos marcos fueron la epidemia de SIDA de la década de 80 y las políticas que la antecedieron. Los datos recolectados suscitan reflexiones sobre los desafíos contemporáneos enfrentados por el empleo de la estrategia de RD en el campo del uso y del abuso de drogas lícitas e ilícitas, como alcohol y crack, el prejuicio vigente en relación al usuario de drogas y la exigencia de intervenciones intersectoriales en el enfrentamiento del fenómeno del consumo de drogas. Además, se mantiene hasta los días de hoy el descompaso histórico entre las políticas sobre drogas oriundas del campo de la seguridad y aquellas provenientes de la salud pública, con predominancia de aquellas de cuño prohibicionista. Mientras tanto, la producción de drogas lícitas e ilícitas se diversifica, generando la necesidad de tornar variadas las acciones de reducción de daños.

The effect of satir model for compulsory drug rehabilitation women / 中国基层医药

Objective To explore the feasibility and validity of Satir model on compulsory drug rehabilitation for female drug users in closed settings. Methods Satir Model-based group psychotherapy was adopted in the treatment on 33 female drug users. Results The findings are that the pre-treatment SCL-90 scores were all higher than norm,indicating very high significant differences(P＜0.01) ; while the post-treatment SCL-90 scores,except the score of somatization, were approximate to norm, showing no statistical differences(P ＞0. 05). Conclusion Satir model played a positive role in the process of female drug users mental health recovery.

Drug Rehabilitation of Spasticity(review) / 中国康复理论与实践

@#Spasticity often results in motor dysfunction, lowering individual abilities of daily living, and limitation of social particitation of the patients, prolonging function recovery, deteriorating quality of life. Drug is helpful to improve spasiticity and reduce complications. But there are some adverse effects in cognition function. Individual medication should be recommended as proposal.

Drug Rehabilitation of Emotion Disorders after Brain Injury / 中国康复理论与实践

@#Agitation, aggression and depression are frequent neurobehavioral sequalae after injury of brain. These behavioural symptoms disrupted patient care and impede rehabilitation effort. In severe cases, the patient even hurts others and sometime injuries himself. This article introduces the use of antipsychotics, mood stablizing, lithium, antianxiety medication and antidepressants especially the SSRIs for the emotion disturbance after injury of brain. Meantime, paper describes the 5-HT syndrome, withdrawal 5-HT syndrome, the neuroleptic malignant syndrome (NMS). The later is owing to wrong use of phenothiazines and butyrophenones. The mortality of NMS is about 25%, if case treats is not correct.

Drug Rehabilitation for Motor Function after Brain Injury / 中国康复理论与实践

@#Motor function is the main function of human being takes place the social activities in the world. Unfortunately, regardless of either CNS or PNS injury, the outcome usually is paralysis. Up to date there is still no drug may restore the function of paralyzed limbs rapidly, completely and satisfactorily. However, the scientist have used drugs to enhance motor function recovery after brain injury and got some effects since the mid of past century, e.g. the amphetamine. The function of amphetamine, notwithstanding was denied by Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care in 2005, however, there were other reports concerning with same purpose study, that may facilitate the recovery of motor function, e.g. Fluoxetine, Selegiline, L-dopa and so on. In the meantime, there also found some drugs with opposite effect and slowing the functional recovery, e.g., Haloperidol, Prazosin, Phenytoin and so forth.

Effect of injection of consciousness-promoted drug through carotid artery on persistent vegetate state / 中国康复理论与实践

@#Objective To observe the therapeutic effect of injection of consciousness promoted drug through carotid artery on persistent vegetate state (PVS).Methods33 PVS cases were divided into the treatment group (n=15) and control group (n=18). All patients were treated with routine therapy, but the treatment group added with injection of consciousness-promoted drug through the carotid artery. The therapeutic effects of two groups were evaluated.ResultsAfter the treatment, the therapeutic effects of patients in two groups were better than that of before treatment (P<0.05), and the treatment group was better than control group(P<0.05).ConclusionInjection of consciousness-promoted drug through the carotid artery is effective to PVS patients.